Document Detail

A technique of fenestration for extracardiac Fontan with long-term patency.
MedLine Citation:
PMID:  19477656     Owner:  NLM     Status:  MEDLINE    
A technique for extracardiac conduit fenestration specifically devised to achieve long-term patency is presented. From 2001 to 2007, 65 patients underwent a fenestrated extracardiac Fontan procedure using this technique where the atrial orifice of the divided inferior vena cava was sutured in an end to side fashion to the leftward aspect of the conduit. The circumferential suture line was centred by the fenestration but remained away from the edge of the latter. All patients receive oral anticoagulation. Clinical and echocardiographic follow-up were obtained. Concurrent follow-up was 100%. There was one early death (mortality 1.5%). Two patients had Fontan failure requiring takedown and another two were transplanted. The fenestration was found to be patent in the rest of patients of the series (n=60) at a median follow-up of 11 months (range 1-91). The mean velocity across the fenestration was 1.6+/-0.55 m/s. No patient required reintervention related to the fenestration. All patients remained in sinus rhythm. This technique is easily reproducible, consistently provides long-term patency and low incidence of complications. The use of inferior vena cava orifice of the right atrium explains the absence of supra ventricular arrhythmias.
Enrique Ruiz; Rafael Guerrero; Yves d'Udekem; Christian Brizard
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Publication Detail:
Type:  Evaluation Studies; Journal Article     Date:  2009-05-27
Journal Detail:
Title:  European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery     Volume:  36     ISSN:  1873-734X     ISO Abbreviation:  Eur J Cardiothorac Surg     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-06-22     Completed Date:  2009-10-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  200-2; discussion 202     Citation Subset:  IM    
Cardiac Surgery Unit, Royal Children's Hospital, Melbourne, Victoria, Australia.
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MeSH Terms
Child, Preschool
Follow-Up Studies
Fontan Procedure / methods*
Heart Defects, Congenital / surgery*
Heart Ventricles / abnormalities
Suture Techniques
Treatment Outcome
Vascular Patency
Vena Cava, Inferior / surgery
Young Adult

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